Expression of Phosphorylated ERK1/2 and cFos Proteins in Vestibular Nuclei by Selective Stimulation of Horizontal Semicircular Canal

BACKGROUND: There is a little information about the effect of selective vestibular stimulation on the expression of activity-dependent metabolic markers in the vestibular nuclei. The purpose of this study was to evaluate effect of afferent excitation of the horizontal semicircular canal on expression of phosphorylated ERK1/2 (pERK1/2) and cFos proteins in the vestibular nuclei. METHODS: The horizontal semicircular canal of Sprague-Dawley rats was selectively stimulated by using the sinusoidal horizontal stimulator with 10-minute duration of stimulation. Conventional immunohistochemical method was used to visualize pERK1/2 or cFos immunoreactive neurons in the vestibular nuclei following rotation. RESULTS: Five minutes after stimulation of the horizontal semicircular canal there was a high expression of pERK1/2 protein in the medial vestibular nucleus among 4 major subnuclei of the central vestibular nuclear complex. On the contrary, immunoreactivity of cFos protein was observed in the medial and inferior vestibular nucleus 2 hours after horizontal sinusoidal rotation. The lateral vestibular nucleus was free from the expression of pERK1/2 and cFos proteins in response to excitation of the horizontal semicircular canal. However, in the vestibular nuclei of unilaterally labyrinthectomized rats expression of pERK and cFos proteins was markedly suppressed in ipsi-lesional side as well as contra-lesional side following stimulation of the horizontal semicircular canal. Furthermore no expression of pERK1/2 and cFos protein in the bilateral vestibular nuclei of bilaterally labyrinthectomized rats was noted after stimulation of the horizontal semicircular canal. CONCLUSIONS: Therefore these results of present study suggest that excitatory afferent signals from the peripheral vestibular receptors are essential for protein translation for pERK1/2 and cFos in response to stimulation of the semicircular canal.

A Case of Colonic Muco-Submucosal Elongated Polyp / 대한소화기내시경학회지

Colonic muco-submucosal elongated polyp (CMSEP) is a rare disease which has been firstly reported by Matake. Only 21 cases have been reported since 1994. Although the mechanism of generation of such polyps remains unknown, their elongation may be caused by intestinal motion for a long period. The occurrence sites were distributed throughout the colon, excluding the rectum. CMSEP is coverd with normal mucosa and consisted of edematous, loose, fibrous, connective tissue and dense, fibrous submucosal layer, often dilatation of blood vessels and lymphatics. We present a case of CMSEP diagnosed by a colonoscopic polypectomy.

The Changes in Esophageal Acidity during Percutaneous Endoscopic Gastrostomy Feeding / 대한소화관운동학회지

BACKGROUND/AIMS: Generally, we try on nasogastric tube (NGT) feeding in brain-injury patients with impaired swallowing. It has been known that percutaneous endoscopic gastrostomy (PEG) tube feeding is less complicated than NGT feeding. However, there is no accurate report for gastroesophageal reflux as complication following PEG and NGT. Therefore, we measured esophageal acidity before and after changing NGT feeding into PEG feeding in management of brain-injury patients, and then evaluated the degree of gastroesophageal reflux. METHODS: Thirteen patients with impaired swallowing in brain-injury were included in this study. They all underwent NGT followed by PEG. Before and after PEG placement, 4 variables of acid exposure were evaluated with 24 hour ambulatory pH monitoring. RESULTS: Number of acid reflux episodes decreased in 5 cases. Number of long acid reflux episodes decreased in 3 cases. Total and fraction time pH below 4.0 decreased in 6 cases. There was no significant difference in improvement of acid reflux between before and after PEG feeding (p>0.05). CONCLUSIONS: Our data showed that acid reflux had a tendency to decrease in patients undergoing percutaneous endoscopic gastrostomy feeding, but it was increased in some of them.

A Case of Idiopathic Granulomatous Pancreatitis / 대한소화기내시경학회지

Granulomatous pancreatitis is a rare disorder and recognized rarely during life or non-operatively. Noncaseating granulomas in the pancreas, histologically indistinguishable from sarcoidosis, can be seen in a variety of diseases such as tuberculosis, fungal infection, berylliosis, Hodgkin's disease, non-Hodgkin's lymphoma and Crohn's disease. Therefore, as with other granulomatous diseases, a tissue biopsy is essential for the diagnosis. Its clinical presentation is often similar to pancreatic cancer, with common presenting symptoms including abdominal pain, weight loss, jaundice, and anorexia. We report a case of idiopathic granulomatous pancreatitis in a 56-year-old women whose clinical and radiographic findings were suggestive of pancreatic cancer.

A Case of Gastritis Cystica Profunda Suspiciously Caused by Gastric Foreign Body / 대한소화기내시경학회지

Gasritis cystica profunda (GCP) is a rare disease in which hyperplasia of mature glandular epithelium extends into the tissues beneath the submucosa. It shows multiple small cysts in the mucosa and submucosa of the stomach. It was firstly reported by Littler and Gleibermann on 1972. GCP is mainly observed at the site of gastroenterostomy but, it may occur in the stomach without a previous history of surgery. The proposed pathogenesis of the these abnormalities are related to ischemia, chronic inflammation and the presence of a foreign body. GCP may present not only as a submucosal tumor or as solitary or diffuse polyps but also as a giant gastric mucosal fold rarely. It should be differentiated from Menetrier's disease, Zollinger-Ellison syndrome, inflammatory disease and malignancy. We present a case of gastritis cystica profunda without having had any previous surgery, suspiciously caused by gastric foreign body. We made a diagnosis based on findings from the esophagogastroduodenoscopy, endoscopic ultrasonography and histologic findings after surgery.

A Case of Anomalous Union of Pancreaticobiliary Drain with Choledochal Cyst and Adenomyomatosis of the Gallbladder / 대한소화기내시경학회지

Anomalous union of pancraeticobiliary drain (AUPBD) is uncommon anomaly of the pancreaticobiliary ductal union system. Usually, this anomaly is confirmed by long common channel (>15 mm) at ERCP and is divided into according to relationship between pancreatic duct and common bile duct. Recently several reports showed that AUPBD may be associated with congenital choledochal cyst and gallbladder carcinoma. A 33-year old man was admitted with RUQ pain and jaundice. Ultrasonography, Abdominal CT, ERCP, and PTBD cholangiography showed type I choledochal cyst, AUPBD and focal adenomyomatosis on the gallbladder. Whipple's operation with excision of the choledochal cyst and chloecystectomy were performed for treatment. This clinical experience suggests that high incidence of choledochal cyst in patients with AUPBD and gallbladder adenomyomatosis are may be closely related to the carcinogenesis of gallbladder cancer in patients with AUPBD.

A case of CMV Gastrointestinal Disease / 대한소화기내시경학회지

Cytomegalovirus(CMV) commonly infects immunocompromised patient, including those with malignant disease, immunosuppression (particularly that induced by steroid therapy), organ transplantation AIDS. Involvement of the gastrointestinal tract is often associated with disseminated infection. Enteric involvement is expressed by inflammation, hemorhage, and ulceration. CMV is postulated to cause submucosal capillary and arteriolor vasculitis that can result in ischemic injury. CMV induced gastritic and colonic ulcers have not previously been reported in Korea. We report a patient of malignancy who had gastric and colonic ulcers assoicated with CMV infection whieh showed chracteristic histological finding of CMV infection in biopsed specimen.

Esophagus, Stomach & Intestine; A Case of Pedunculated Liposarcoma in Esophagus: A case report / 대한소화기내시경학회지

Liposarcoma in esophagus is rare, moreover the pedunculated form is very rare. We experienced a case of liposarcoma in a 36-year-old man who had intermittent swallowing difficulty for 7 months. Endoscopy and esophagography revealed that a smooth longitudinal tumor mass occupied the esophageal lumen. Esophagotomy and surgical excision was done. The tumor was 4 cm in length and 3 cm in average diameter with an obvious stalk measuring 3.5 cm in length and 1.5 cm in diameter. Microscopic examination disclosed a lipoma with focal ulceration and liposarcomatous change infiltrating into interstitial fibrous tissue at its distal end.